RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00344
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040213

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Automated Logistical Specialist, medically separated for “bilateral hip pain,” with a disability rating of 10%.

CI CONTENTION:  The CI made no contention.  The CI’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited to those conditions determined by the Physical Evaluation Board (PEB) to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting.  Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military Records.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is based upon a review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation.  The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation. 

RATING COMPARISON:  

SERVICE PEB - 20040102	VARD - 20050304	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Hip Pain	5099-5003	10%	Snapping Hip Syndrome, Bilateral	5299-5255	NSC	NA	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NSC	

ANALYSIS SUMMARY:  

Bilateral Hip Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI first reported left hip pain after a road march in October 2002.  Her examination and X-ray were normal she was treated for a bursal (a fluid filled sac to reduce infection) inflammation.  Her pain persisted and also involved the right side.  A bone scan on 6 May 2003 was normal for both hips.  Her gait was noted to be normal in primary care on 6 June 2003.  She was seen in orthopedics on 20 June 2003 and noted to have full and pain free motion of the hips.  Her examination was stable.  The examiner was unable to reproduce the “snapping hips” reported subjectively.  She was again referred for physical therapy.  Her pain persisted and she was referred for an MEB for “snapping hip syndrome” (coxa saltans).  

The MEB NARSUM examination dated 21 November 2003, 3 months prior to separation, recorded complaints of pain with any strenuous activity.  On examination, her motor function was normal.  She had full but painful range of motion.  She was noted to be able to sublux (a partial dislocation) her hips bilaterally by standing.  The Board noted that this was not recorded at the orthopedic examination.  The NARSUM examination was dictated by a primary care physician’s assistant who also accomplished the examination (DD Form 2808) which was done the same day.  The CI did not report for the VA Compensation and Pension (C&P) evaluation scheduled for 15 December 2004.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral hip condition at 10%, coded 5099-5003 (analogous to degenerative arthritis) IAW the USAPDA pain policy.  The VA determined that the snapping hips syndrome was a congenital or developmental condition which was unrelated to military service and not subject to service-connection. The Board considered the findings.  Painful motion was present and supports a 10% rating for each hip IAW VASRD §4.59 (painful motion).  The ROM was normal as was the motor examination, X-rays, and the bone scan.  The gait, when recorded, was normal.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the each hip condition, coded 5255.  

BOARD FINDINGS:  In the matter of the bilateral hip condition, the Board unanimously recommends a disability rating of 10% for each knee, coded 5255 IAW VASRD §4.71a.  There were no other conditions within the Board’s scope of review for consideration.  

The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Left Hip Pain	5255	10%	
Right Hip Pain	5255	10%	
COMBINED	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150529, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB										

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

21 DEC 2016

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20160018685   (PD201500344)

1.  I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under the authority of Title 10, United States Code, section 1554a, accept the Board’s recommendation to modify the individual’s disability rating to 20% without re-characterization of the individual’s separation.  This decision is final.  

2.  I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.   

3.  I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

 BY ORDER OF THE SECRETARY OF THE ARMY:

CF: 
(  ) DoD PDBR
(  ) DVA